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Received:March 06, 2023 Published Online:November 20, 2023
Received:March 06, 2023 Published Online:November 20, 2023
中文摘要: 目的 探讨超声影像学特征联合血清促甲状腺激素(TSH)、甲状腺球蛋白(TG)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)评估甲状腺乳头状癌(PTC)侵袭性的价值。方法 分析2022年1月至12月南通大学附属通州医院经手术病理证实的587例PTC患者,根据术后病理结果将其分为转移组(n=235)及对照组(n=352)。比较两组患者年龄、性别和PTC位置、大小、结构、回声、形态、边缘、钙化、与甲状腺被膜的关系、PTC血供超声特征,以及血清TSH、TG、TGAb及TPOAb水平,分析各特征与颈部淋巴结转移的相关性。结果 两组PTC患者的结节全为实性,且位置、结构、内部回声,形态纵横比差异无统计学意义(P>0.05)。两组病例中结节最大径、边缘、钙化、与甲状腺被膜的关系、血供差异有统计学意义(P<0.05)。Logistic回归分析显示,结节最大径、边缘、血供、与甲状腺被膜的关系以及血清TSH、TG、TGAb、TPOAb水平是PTC转移的独立影响因素(P<0.05)。结论 超声影像学联合血清TSH、TG、TGAb及TPOAb对术前评估PTC侵袭性有重要临床意义。
Abstract:Objective To investigate the combination of ultrasound imaging features and serum thyroid stimulating hormone (TSH), thyroglobulin (TG), thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) in evaluating the risk of invasive papillary thyroid carcinoma (PTC). Methods A total of 587 patients with PTC confirmed by surgery and pathology in Affiliated Tongzhou Hospital of Nantong University from January 2022 to December 2022 were analyzed and were divided into metastasis group (n=235) and control group (n=352) according to postoperative pathological results. The age, gender, location, size, structure, echo, shape, margin, calcification, relationship with thyroid capsule, ultrasound characteristics of blood supply of PTC and serum level of TSH, TG, TGAb and TPOAb were compared between the two groups, and the correlation between these characteristics and cervical lymph node metastasis was analyzed. Results The nodules of the two groups of PTC patients were all solid, and there was no statistically significant difference in position, structure, internal echo, and aspect ratio of morphology (P>0.05). There were statistically significant differences in the maximum diameter, margin, calcification, relationship with thyroid capsule, and blood supply of nodules between two groups (P<0.05). Logistic regression analysis showed that maximum diameter, margin, blood supply, relationship between nodules and thyroid capsule, and serum level of TSH, TG, TGAb, TPOAb were independent influencing factors for PTC metastasis (P<0.05). Conclusion Ultrasound imaging combined with serum TSH, TG, TGAb, and TPOAb has important clinical significance for preoperative assessment of PTC invasion.
keywords: Papillary thyroid carcinoma Ultrasound imaging Lymph node metastasis Thyroid stimulating hormone Thyroglobulin Thyroglobulin antibody Thyroid peroxidase antibody
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基金项目:南通市民生科技计划项目面上项目(MS22022023)
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